Is cupping therapy a significant risk factor for transfusion-transmitted infections? Evidence from a systematic review

Background and ObjectivesCupping therapy (Hijama), as a common method of treatment in the world, could carry a significant risk of infections by bloodborne pathogens.We aimed to review systematically scientific reports on the relationship between cupping practices and bloodborne infections. Materials and MethodsIn this systematic review, international and local databases were searched using relevant keywords.All original citations published in English or Persian up to March 2024 were included.No limitations were applied to study design, sample size, publication date, or cupping techniques. ResultsAfter screenintg the titles and abstracts of 630 studies retrieved from the initial search, the full texts of 67 non-duplicate documents were reviewed.Of these, 42 articles were excluded for various reasons.A manual search of the references from the retrieved papers yielded 6 additional articles, resulting in a total of 29 studies that fulfilled the inclusion criteria after excluding two overlapping citations.Among the 15 surveys that assessed HBV infection, only 3 demonstrated a positive association between a history of cupping and this infection using multivariate analysis; the reported odds ratios ranged 3.8 to 7.3.Regarding HCV infection, 2 of 13 investigations confirmed a positive correlation with cupping therapy in multivariate regression analysis; the reported odds ratios were 2.3 and 2.4.No reports indicated a significant relationship between cupping therapy and HDV, HIV, or HTLV-1 infections. ConclusionsThis systematic review revealed that there is insufficient evidence regarding the role of cupping in the spread of bloodborne infections.It is recommended to conduct large-scale and longitudinal studies to find if this traditional practice is a significant risk factor for infection.